Nonalcoholic fatty liver disease: a manifestation of the metabolic syndrome.
Nonalcoholic fatty liver disease (NAFLD) has become the most common form of liver disease, affecting 20% to 30% of the US population. Its clinical manifestations are usually absent or subtle, and it usually comes to medical attention incidentally when aminotransferase levels are found to be elevated or a radiographic study reveals that the liver is fatty. Primary NAFLD is now considered the hepatic manifestation of the metabolic syndrome. The pathogenesis is thought to be a multiple-hit process involving insulin resistance, oxidative stress, apoptosis, and adipokines. In general, the prognosis for simple steatosis is very good; however, nonalcoholic steatohepatitis (NASH) can progress to cirrhosis and hepatocellular carcinoma in 10% to 15% of patients. There is no established treatment for NAFLD except for weight loss and treating each component of the metabolic syndrome.
Kim
Chin Hee
CH
Center for Liver Diseases-INOVA Fairfax Hospital, Falls Church, VA 22042, USA.
Younossi
Zobair M
ZM
D017209:Apoptosis; D002986:Clinical Trials as Topic; D003937:Diagnosis, Differential; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000209:etiology; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000209:etiology; D024821:Metabolic Syndrome / Q000150:complications* / Q000628:therapy; D018384:Oxidative Stress; D011379:Prognosis; D015431:Weight Loss